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Parkinson's Disease

 

In 2010 I was diagnosed with Parkinson's disease. Although diagnosed in 2010, the symptoms appeared as early as 2004. The first symptoms were rigidity and pain in my right shoulder. Having just turned 40 my doctor said it was just a part of growing older. He gave me pain killers and sent me home. But I had a feeling that there was more to it than that. I had always been an athlete and had cultivated a lifelong habit of daily exercise. I hold a 5th degree black belt in Shotokan karate and represented Australia in competition. I was also a competitive dancer in the Modern Jive style where I had won international championships. But now, my body seemed to be changing quicker than natural aging.

There was a progression of symptoms. My arm stopped swinging while I was walking. Then there was a deterioration of my fine motor skills. I went from typing 60 words per minute to struggling with just two fingers. My hand writing was cramped and tiny.

I went to more doctors and physiotherapists but they kept misdiagnosing my condition. This is very common in the early stages of the disease. I did not have any tremors at this stage. Tremors are the dead give away for Parkinson's disease.

On Valentine’s Day, 14th of February 2007, I took my first Bikram yoga class. By this stage, my shoulder pain had increased and I had a sharp pain in my neck. If I turned my head to the right, the pain was so sharp that it brought tears to my eyes.

A friend had told me about Bikram yoga many years before. I had always used saunas and hot tubs to treat injuries related to karate and dancing. So I figured gentle stretching in a hot room might help alleviate some of my problems.

I took my first yoga class at the Bondi Junction studio in Sydney. I took it pretty easy first class and enjoyed the gentle stretching. I do remember thinking “Wow, there is a lot of lying down in this practice”. That day, I picked up a copy of Bikram’s beginner book and read it that night. Bikram’s sense of humor and the confidence he seemed to have in his style of yoga, inspired me. I immediately started a 60 day challenge. 60 days later I completed the challenge.

The difference that the practice had made was amazing. When I started the challenge, the pain in my neck was so bad that trying to touch my chin to my shoulder during triangle was agonizing. Even turning my head to the right and left during the belly down savasanas was excruciating. But I was slow and gentle with myself and every day there was a small improvement. Day by day, little by little, the pain decreased. By the end of the 60 days there was no more pain, and I have remained pain free since then (provided I keep up a regular practice). If I take a week off, which I rarely do, I suffer.

In 2009, the owner of my home studio strongly encouraged me to think about teacher training. I had already been teaching him karate. He thought that I would make a good yoga teacher. After some soul searching, I decided to go to the fall 2009 training in Las Vegas.

Still undiagnosed, the physical, mental and emotional strain of training exacerbated my symptoms. The tremors became more pronounced, and the rigidity in my right hand side became more obvious. By Week 7 it was not hard for Doctor Aaron, the chiropractor, to diagnose Parkinson’s disease. The tremors were a dead give away. He said I needed to see a neurologist as soon as I got home.

I immediately googled Parkinson’s disease. It was obvious from all the symptoms that he was right. Parkinson’s disease can be quite horrific. It is progressively degenerative which means the symptoms keep getting worse until you are completely non-functioning. There is no cure, just medication to help with the symptoms for a while, but eventually even medication doesn’t work.

I must admit, for the last two weeks of teacher training I had some pretty dark thoughts. My first thought was to jump off a bridge. But then a funny thing happened. Once I was not afraid to die, I was no longer afraid to live. My whole world view changed. And luckily, I was ensconced in the yoga bubble surrounded by loving, compassionate, yogi healers.

The biggest lesson I had learned from teacher training was that craziness is not caused by things that were happening around me. It was caused by the thoughts in my own mind. I decided not to dwell on pessimistic thoughts of the future. I would let “Future Dave” worry about that, when and if it happened. Dwelling on pessimistic thoughts just causes suffering in the present. And in the present, I felt I OK.

I went back home and was officially diagnosed with Parkinson’s in January, 2010. I am blessed that I live in Australia. Australians are very kind to people with disabilities. I was allowed to cash in my disability insurance and retire from my job in adult education teaching computer studies, a position I had a held for 22 years.

I still teach yoga and karate. I am well rested, well exercised and well medicated. I have the freedom to be the person I have always wanted to be. I have visited every teacher training and get great joy and love out of helping other people become yoga teachers. And my personal practice of Bikram yoga balances out my emotions and keeps me happy and joyful.

I am really no less happy now than before I had Parkinson’s disease. I enjoy living in the present. Every moment is a gift. As Michael J. Fox so eloquently pointed out “Parkinson’s disease is the gift that keeps on taking”.

How has Parkinson’s disease affected my yoga practice?

There are 4 main symptoms of Parkinson's disease that can be remembered by the acronym TRAP: Tremor, Rigidity, Akinesia and Posture/Balance.

Tremor is the most apparent and well-known symptom. It is a resting tremor. A feature of tremor is "pill-rolling", a term used to describe the tendency of the index finger of the hand to get into contact with the thumb and perform together a circular movement.

Rigidity is stiffness and resistance to limb movement caused by increased muscle tone, an excessive and continuous contraction of muscles. In early stages of Parkinson's disease, rigidity is often asymmetrical and it tends to affect the neck and shoulder muscles prior to the muscles of the face and extremities. With the progression of the disease, rigidity typically affects the whole body and reduces the ability to move.

Akinesia (slowness of movement) is the most disabling symptom in the early stages of the disease. Initial manifestations are problems when performing daily tasks which require fine motor control such as writing, sewing or getting dressed.

Postural instability is typical in the late stages of the disease, leading to impaired balance and frequent falls.

If you watch my practice, you will see manifestations of all four symptoms. The most obvious is the tremors. But they are not the most debilitating symptom.

The rigidity has limited my movements in a lot of the postures. But through daily practice, I now have a better range of motion than before I began yoga. I’m sure without the Parkinson’s disease my range of motion would be much greater. That being said, I am still miles ahead of most men my age. I do tend to cramp up from the rigidity which means I tend to come out of postures early. My teachers are very understanding and they know that even if I come out early, I have still done 110%.

The biggest problem is balance. I tend to fall out of balancing postures to the right. But if I concentrate, I can still manage the balancing postures. But each time I try, it is like I am doing the posture for the first time. I do not have the muscle memory that other yogis take for granted. I have to concentrate on all parts of my body at all times.

The final symptom is slowness of movement. I move very slowly between postures. If I try to move faster, I lose my balance.

What is Parkinson's disease?

Parkinson's disease is a progressively degenerative disorder of the central nervous system.

The primary symptoms of Parkinson's disease result from greatly reduced activity of dopamine-secreting cells caused by cell death in the substantia nigra in the brain. Dopamine is a neurotransmitter responsible for relaying messages from the brain to the movement centers of the body.

Parkinson's disease is idiopathic (having no known cause).

Modern treatments are effective at managing the early motor symptoms of the disease, mainly through the use of levodopa. As the disease progresses and dopamine producing neurons continue to be lost, a point eventually arrives at which these drugs become ineffective at treating the symptoms and at the same time produce a complication called dyskinesia, marked by involuntary writhing movements.

Surgery and deep brain stimulation have been used to reduce motor symptoms as a last resort in severe cases where drugs are ineffective. Research directions include stem cell transplants.

People with Parkinson's disease who have enhanced the public's awareness include Michael J. Fox and Muhammad Ali.

Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer's disease. The prevalence (proportion in a population at a given time) of Parkinson’s disease is about 0.3% of the whole population in industrialized countries. Parkinson’s disease is more common in the elderly and prevalence rises from 1% in those over 60 years of age to 4% of the population over 80. The mean age of onset is around 60 years, although 5–10% of cases, classified as young onset, begin between the ages of 20 and 50.

David Fox

 

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